Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Development of a Self-Reported Frailty Index - the SELFI (#266)

Aaron Din How Sia 1 2 , Peter Mollee 1 , Robyn Berry 1 , Rahul Ladwa 1 , Victoria Ling 1 , James Fletcher 1 2 , Emily Gordon 1 2 , Euan Walpole 1 2 , Leila Shafiee Hanjani 2 , Natasha Reid 2 , Camilla Simonsen 1 , Ruth Eleanor Hubbard 1 2
  1. Princess Alexandra Hospital, Brisbane, QLD, Australia
  2. The University of Queensland, Brisbane, QLD, Australia

Background
Routine implementation of geriatric assessment (GA) to quantify frailty improves outcomes in cancer care, yet time and resource barriers in fast-paced clinic settings often preclude implementation. A pragmatic GA delivery format balancing concision without compromising on detail is needed. We aim to develop a self-administered paper questionnaire, the SELFI, based on consumer feedback as a user-friendly tool able to provide a compendious frailty assessment at scale.

Methods
The short-form frailty index (FI) is a nurse-administered multidimensional GA tool validated in both oncology and non-oncology contexts. As part of a pilot phase, we converted the FI to a paper-based questionnaire intended to be completed by patients and their caregivers without staff input. The questionnaire was administered to cancer survivors attending a tertiary hospital oncology outpatient department. Feedback from users was elicited using “Think Aloud” techniques, a validated method of questionnaire development, and was used to iteratively revise the questionnaire until feedback ceased to identify major issues for revision.

Results
13 participants provided questionnaire feedback, informing 18 different questionnaire versions before completion of the revision process. Issues identified for revision included presentation (font size, colour scheme and order of presented items), semantic and grammatical phrasing of questions and simplification of medical jargon. The median time for questionnaire completion was 26 minutes (range: 10-43 minutes). Participant feedback was positive, with the questionnaire perceived as a useful tool to raise awareness about unmet needs.

Conclusion and Future Directions
The SELFI is a self-administered GA tool developed through an extensive revision process incorporating patient feedback. This tool will be now be validated against a nursing administered FI gold standard (phase 2). Once validated, it will offer an efficient way to quantify frailty in oncology settings and provide a route to GA implementation at scale.